Arab American Leader Breaks Silence About HIV/AIDS

In Arab communities it's taboo to talk about sex. People are afraid you can get HIV just by talking about it.

He packs up his bag for work -- HIV/AIDS pamphlets, condoms, and HIV tests -- and heads off to his field office -- gay bars, clubs, and bathhouses. At 10:30 pm while many people are heading off to bed, Christiano Ayoub Ramazzotti's workday is just beginning.

Ramazzotti has spent the past five years providing HIV/AIDS education and testing outreach primarily to Arab American immigrants and refugees from diverse ethnic and religious backgrounds in the greater Detroit area. Born in Beirut, Lebanon, Ramazzotti moved to Michigan in 1990 at the age of 20. According to the Arab American Institute, an estimated 500,000 Arab Americans live in Michigan -- a state that comprises the second largest concentration of people of Arab descent living outside of the Middle East.

In the U.S., approximately 40,000 people are newly infected with HIV each year. More than one million Americans are living with HIV/AIDS. One-fourth of people infected do not know that they are HIV positive. "If you don't know how HIV is transmitted, you can't avoid the infection. If you don't know if you're infected, you can't receive treatment," says Ramazzotti.

"In Arab communities it's taboo to talk about sex. People are afraid you can get HIV just by talking about it," Ramazzotti said. Ramazzotti, an Arab American, has worked hard to break the silence and educate people in his community, especially men who have sex with men (MSM) and high-risk heterosexuals, about HIV.

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Ramazzotti is the HIV/AIDS Sexually Transmitted Infection (STI) Prevention Coordinator at The Arab Community Center for Economic and Social Services (ACCESS) Community Health and Research Center. The Center is the most comprehensive Arab American community-based health and mental health center in North America. It provides accessible, affordable, and holistic health services.

In a typical day, Ramazzotti spends the first part of his day at the Center overseeing the HIV/AIDS testing and counseling program and managing research projects. He then uses the bulk of his time to conduct HIV/AIDS education and outreach in the community, "bringing testing to clients." ACCESS performs "approximately 80% of all its HIV tests in the field at night", according to Ramazzotti.

In the evening Ramazzotti visits several bars, clubs, and bathhouses, all of which have a written agreement with ACCESS allowing Ramazzotti permission to do his work there. At each site Ramazzotti walks around and talks to people asking if they want information, condoms, or an HIV test. "Chris is one of the bravest people I know," said Craig Covey, CEO of Midwest AIDS Prevention Project and long-time Gay political activist. "I am in awe of how well he has helped organize the gay Arabic community when no one else had the courage to do so," he added.

At each location Ramazzotti has secured a private area, usually a storage area or office, where he performs private, safe, and confidential HIV testing and counseling. The test involves taking a quick swab from the client's mouth.

After the test, Ramazzotti sets up appointments for clients to get their results three days later at ACCESS' Community Health and Research Center. Once there, clients are often linked with additional services such as medical care, and social, mental health, and legal services. For the few clients that are not able to come to ACCESS for their results, Ramazzotti arranges to meet them where he performed the test.

At around 3:45 am Ramazzotti returns home. Despite his odd hours and often challenging work, Ramazzotti continues his outreach day after day working on the frontline, entering places that are taboo to many, in order to help break the silence about HIV in the Arab American community -- "Silence equals death."

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